=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609586148
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | QUILTED HEALTH NC, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/23/2022
-----------------------------------------------------
Last Update Date | 11/23/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 390 S FRENCH BROAD AVE STE B
-----------------------------------------------------
City | ASHEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28801-4365
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-451-1288
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1329 N 47TH ST UNIT 31112
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98103-6787
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-451-1288
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | REVENUE CYCLE MANAGER
-----------------------------------------------------
Name | ROCHELLE D TATE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 206-451-1288
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 367A00000X
-----------------------------------------------------
Taxonomy Name | Advanced Practice Midwife
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------